It started with intense rage. I was constantly irritated and angry at everything. From the piles of laundry to the piles of work, I was feeling somewhat out of sorts. Then came the weight gain, missed periods, sleepless nights and immense lethargy and I knew that the onset of perimenopause had started.
I was 48 at the time, so it was only a matter of time before nature took its course, but I had never imagined it to be that terrible and that I’d feel so markedly different.
But I did and I needed to fix it. Quickly before my rage took on a life of its own.
The weight gain for me was the worst. Being a nutritionist I have always followed a healthy and balanced meal plan, but with no change to my diet, the sudden extra pounds had me flummoxed. What was I doing wrong? How was I gaining weight with no change to my diet or exercise plan?
I started to do some research and the findings were fascinating and I discovered that significant hormonal changes were impacting my body in various ways, including weight gain.
Perimenopause is characterised by fluctuating estrogen levels and a gradual decline in progesterone, which drastically affects how and where my body stores fat. As I was experiencing perimenopause, my ovaries were producing unusually high estrogen levels due to impaired communication between the ovaries, hypothalamus, and pituitary gland.
However, as I progressed through this phase, and especially as my menstrual cycles became more irregular, my estrogen production was significantly dropping. This hormonal shift led to an increase in weight, particularly around my abdomen, as my body began storing more visceral fat.
Unlike the subcutaneous fat stored in hips and thighs, this visceral fat is linked with higher risks of insulin resistance, type 2 diabetes, heart disease, and other health problems.
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During this transition, I noticed an average weight gain of about two to five pounds (1–2 kilograms), though I realised that some women might experience more, especially if they were already overweight. This weight gain isn't solely attributable to hormonal changes; aging also plays a significant role.
A study I came across involving women aged 42–50 found that there was no significant difference in average weight gain between those who were menopausal and those who weren't.
The Study of Women’s Health Across the Nation (SWAN) provided me with insights into these changes. It highlights an increase in belly fat and a decrease in muscle mass among middle-aged women during perimenopause.
Additionally, changes in appetite and calorie intake might contribute to weight gain during this period. I learned that levels of ghrelin, the hormone that stimulates hunger, are higher in perimenopausal women.
Plus, the decreasing estrogen levels in the late stages of perimenopause can disrupt the function of leptin and neuropeptide Y, hormones that regulate satiety and appetite, potentially leading me to consume more calories, without realising.
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While the role of progesterone in weight changes during menopause is less understood, I believe that the combination of low estrogen and progesterone levels might increase the risk of obesity.
Thankfully, through my research, I also found some strategies to help manage the symptoms and to get me back to feeling (almost) normal. Here’s what I did...
How I managed perimenopause
Reducing carbohydrates: I focus on cutting back on carbs to reduce the accumulation of belly fat.
Increasing fibre intake: I incorporate a diet high in fibre, including flaxseeds, to improve my insulin sensitivity.
Increasing protein intake: Adding more protein to my diet helps me feel fuller for longer, reduced cravings, and aid in preserving lean muscle mass.
Eating less: Adjusting my calorie intake became crucial as I needed about 200 fewer calories daily in my 50s compared to my 30s and 40s. I emphasised fruits, vegetables, whole grains, legumes, nuts, soy, fish, and low-fat dairy, while limiting red meat and processed foods.
Reducing sugar and alcohol: Minimising added sugars and alcohol helps me significantly cut down on unnecessary calories, plus improve overall mood and sleep.
Engaging in strength training: This helps me improve my body composition and maintain lean muscle mass.
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Prioritising rest and relaxation: Ensuring good sleep and managing stress is vital for maintaining hormonal balance and managing my appetite.
Adopting these lifestyle modifications helped me navigate the complex changes of perimenopause and maintain my health and well-being.
Faye James is an accredited nutritionist, member of the Australian Menopause Society and author of The Menopause Diet